Ovarian carcinoma is disease that eludes early diagnosis and has a high mortality rate. In a diagnosis of ovarian carcinoma, one of the most common problem is to distinguish between a primary ovarian and colorectal adenocarcinoma. Colorectal adenocarcinomas metastatic to the ovary may closely resemble primary ovarian endometrioid or mucinous adenocarcinomas (1) and the morphological distinction is difficult.
Monoclonal antibodies raised against tumour-associated antigens have been widely used in pathological practice, especially in the determination of the likely primary site of an adenocarcinoma when this is not known clinically. In the case of ovarian cancer these antibodies have not proven sufficiently specific and their value is limited in a diagnostic sense. Antibodies such as CA125 and human alveolar macrophage (HAM) 56 have been proposed as useful immunohistochemical markers of ovarian adenocarcinoma but immunoreactivity is often present in adenocarcinomas of other sites, limiting their diagnostic value. (2,3) Anticytokeratin (CK) antibodies are of value in certain diagnostic situations, especially in the distinction between a primary ovarian adenocarcinoma (usually CK7+, CK20−) and a colonic adenocarcinoma (usually CK7−, CK20+). (4,5) However, these antibodies are of no value in the distinction between an ovarian primary and an adenocarcinoma arising in the stomach, breast, pancreas or biliary tree, since these tumours share a common anti-CK immunoprofile.
In addition, the serological test using CA125 has been used for monitoring disease progression or recurrence after treatment but it is not sensitive enough for early detection of such tumours and gives false positive results in other clinical conditions. The CA125 MAb cannot be used for immunocytochemical detection in routine pathological specimen, as it does not react with the denatured antigen in these tissues.
Accordingly, a need exists to provide an improved diagnostic tool and method for detecting an ovarian carcinoma cell.